(PS1-63) The effects of a single-session intervention for self-stigma on shame and self-esteem

Abstract Text: Introduction
Self-stigma, the extent to which people with mental illness internalize and identify with negative beliefs and stereotypes, is associated with a host of harmful psychological and treatment outcomes (e.g., increased symptom severity and decreased engagement with and response to treatment; Dubreucq et al., 2021). Two of the most commonly reported correlates of self-stigma are shame and self-esteem (Livingston & Boyd, 2010). While mindfulness- and acceptance-based interventions are effective at addressing self-stigma and shame (Stynes et al., 2022), few studies examine whether brief interventions could effectively target self-stigma and its correlates. Nauphal and colleagues (2025) piloted a single-session mindfulness- and acceptance-based group intervention that was acceptable to users and observed significant reductions in self-stigma over time. This present study extends this work by exploring the relationship between self-stigma, shame, and self-esteem in this sample and whether participants also reported changes in shame and self-esteem.

Methods
Participants (N=39, 58.9% female, 84.6% white) were recruited from waitlists for outpatient clinics, and participated in a two-hour, virtual, group-based intervention targeting self-stigma (see Nauphal et al., 2025 for more details). Measures of self-stigma (SSS, Mak & Cheung, 2010), shame (ISS, Cook, 2001), and self-esteem (RSES, Rosenberg, 1979) were administered at baseline, one week following the workshop (W1), and one month following the workshop (1MFU).

Results
At baseline, ISS shame scores were positively correlated with SSS self-stigma total scores (r (38) = .515, p < .001), and were negatively correlated with RSES self-esteem total scores (r (37) = -.808, p < .001). RSES self-esteem scores were also negatively correlated with SSS total scores (r (37) = -.461, p = .003). A repeated measures ANOVA found there was a significant effect of time on ISS scores, indicating shame decreased significantly across time (F(2,66) = 3.774, p = .028). A Bonferroni correction for post-hoc pairwise comparisons indicated a significant change between baseline and W1 (p = .006), while there were no significant changes in shame between baseline and 1MFU (p = .472), or between W1 and 1MFU (p = .825). There were no significant effects of time on RSES self-esteem scores (F (2, 66) = 1.607, p = .208). Correlations between unstandardized gain scores for SSS stigma scores and ISS shame scores were significant from baseline to W1 (r = .491, p = .002) and from baseline to 1MFU (r = .555, p < .001), indicating that change in shame is associated with change in self-stigma.

Discussion
Results suggest that a single-session intervention for self-stigma may effectively reduce shame, at least in the short-term, and that change in shame is associated with change in self-stigma. However, this intervention may not be sufficient for increasing self-esteem in individuals with anxiety disorders. Additional research is needed to better understand how brief interventions can be leveraged to reduce self-stigma and related constructs.